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Abstract:

In an electrophysiology (EP) lab, a bedside interface device allows an EP
physician to directly control various diagnostic and therapeutic systems,
including an electro-anatomic mapping system. The bedside interface
device can include a computer with wireless communication capability as
well as a touch-responsive display panel and voice recognition. The
bedside interface device can also be a hand-graspable wireless remote
control device that is configured to detect motions or gestures made with
the remote control by the physician, allowing the physician to directly
interact with the mapping system. The bedside interface device can also
be a motion capture camera configured to determine motion patterns of the
physician's arms, legs, trunk, face and the like, which are defined in
advance to correspond to commands for the mapping system. The bedside
interface device may also include voice recognition capabilities to allow
a physician to directly issue verbal commands to the mapping system.

Claims:

1. A device for allowing a user to control an electro-anatomic mapping
system, comprising: an electronic control unit; input means executing on
said electronic control unit for acquiring a user input with respect to a
view of an anatomical model of at least a portion of a body of a patient
produced by the mapping system, said user input selected from the group
comprising a user touch, a user multi-touch, a user gesture, verbal
command, a motion pattern of a user-controlled device, a user motion
pattern and a user electroencephalogram, said electronic control unit
being configured to communicate said acquired input to the mapping
system.

2. The device of claim 1, wherein said acquired user input corresponds to
at least one of: creating a map with respect to said view; collecting
points with respect to said view; segmenting regions by anatomy with
respect to said view; rotating said view; enlarging or reducing a portion
of said view; panning said view; selecting one of plurality of maps for
said view; selecting a signal trace for display; adjusting a signal
amplitude; adjusting a sweep speed; recording a segment; placing an event
marker; placing a lesion marker with respect to said view; activating a
replay feature of a stored, temporally varying physiologic parameter;
activating a replay of a stored video clip.

3. The device of claim 1 wherein said input means includes a
touch-responsive display panel coupled to said electronic control unit
and further including user interface logic stored in a memory configured
to be executed by said electronic control unit, said user interface logic
configured to display on said panel a user interface, said user interface
logic being further configured to allow a user to interact with the
touch-responsive panel and acquire said input from the user.

4. The device of claim 3 wherein the mapping system is one of a plurality
of electrophysiological diagnostic and therapeutic systems, said user
interface logic being configured to selectively present a respective user
interface to enable access to and control of one of said
electrophysiological systems.

5. The device of claim 4 wherein said user interface logic is further
configured to switch between respective user interfaces via a common
interface displayed on said touch-responsive display panel.

6. The device of claim 4 wherein said user interface logic is further
configured to allow the user to control a plurality of said
electrophysiological systems through a single input from the user.

8. The device of claim 3 further including voice recognition logic stored
in said memory and configured to analyze speech input from the user and
determine a command for the mapping system.

9. The device of claim 8 wherein said user interface logic is configured
to allow the user to enable or disable the operation of the voice
recognition logic.

10. The device of claim 3 wherein said user interface logic is configured
to produce a joystick object on the touch-responsive display panel, said
joystick object being configured to detect a direction input with at
least respect to said view of said model.

11. The device of claim 10 wherein said joystick object is further
configured to detect a magnitude input with at least respect to said view
of said model.

12. The device of claim 11 wherein said joystick object includes a circle
having a center and a perimeter, said magnitude input corresponding to a
distance from said center toward said perimeter at which the user touches
said touch-responsive display panel.

13. The device of claim 12 wherein said magnitude input adjusts an
acceleration of said view of said model or a cursor.

14. The device of claim 12 wherein said view is displayed on a monitor
different from said touch-responsive display panel.

15. The device of claim 3 wherein said user input logic is configured to
allow the user to set the mapping system in a follow-me mode wherein the
user input is used to control rotation of the view of the model while a
representation of a catheter with respect to said view is stationary.

16. The device of claim 1 wherein said input means includes a remote
control having a handle configured to be grasped by the user, and logic
stored in a memory configured to be executed by said electronic control
unit, said logic being configured to acquire said input from the user and
wherein said electronic control unit is configured to communicate said
acquired input to the mapping system.

17. The device of claim 16 wherein said remote control is integrated with
a medical catheter.

18. The device of claim 1 wherein said input means includes a motion
capture apparatus configured to acquire imaging of movements of the user
and logic stored in a memory configured to be executed by said electronic
control unit, said logic being configured to determine a motion pattern
from said acquired imaging, said logic being further configured to
produce a command, based on said determined motion pattern, and
communicate said command to the mapping system for modifying the view of
the anatomical model.

19. The device of claim 1, wherein said model comprises one of a
three-dimensional geometry of an anatomical feature, a map of an
electrophysiological parameter, and a three-dimensional geometry or map
of said anatomical feature from an imaging system.

20. The device of claim 19 wherein said imaging system comprises one of a
fluoroscopic system and an ultrasound imaging system using an
intra-cardiac echocardiography catheter.

21. A device for allowing a user to control an electro-anatomic mapping
system, comprising: an electronic control unit; a computer-readable
memory coupled to said electronic control unit; a touch-responsive
display panel coupled to said electronic control unit; and user interface
logic stored in said memory configured to be executed by said electronic
control unit, said user interface logic configured to display on said
panel a user interface, said user interface logic being further
configured to allow a user to interact with the touch-responsive panel
and acquire an input from the user with respect to a view of an
anatomical model of at least a portion of a body of a patient produced by
the mapping system, said electronic control unit being configured to
communicate said acquired input to the mapping system.

22. A device for allowing a user to control an electro-anatomic mapping
system, comprising: a remote control having a handle configured to be
grasped by the user, said remote control including an electronic control
unit, and a computer-readable memory coupled to said electronic control
unit; logic stored in said memory configured to be executed by said
electronic control unit, said logic being configured to acquire an input
from the user with respect to a view of an anatomical model of at least a
portion of a body of a patient produced by the mapping system, said
electronic control unit being configured to wirelessly communicate said
acquired input to the mapping system.

23. A device for allowing a user to control an electro-anatomic mapping
system, comprising: a motion capture apparatus configured to acquire
imaging of movements of the user; an electronic control unit and a
computer-readable memory coupled to said electronic control unit; and
logic stored in said memory configured to be executed by said electronic
control unit, said logic being configured to determine a motion pattern
from said acquired imaging, said logic being further configured to
produce a command, based on said determined motion pattern, and
communicate said command to the mapping system for modifying a view an
anatomical model of at least a portion of a body of a patient produced by
the mapping system.

Description:

BACKGROUND OF THE INVENTION

[0001] a. Field of the Invention

[0002] The instant disclosure relates generally to electrophysiology lab
integration, and more particularly to user interfaces and devices
therefore for electrophysiology lab diagnostic and therapeutic equipment.

[0003] b. Background Art

[0004] It is known to provide an electrophysiology lab in a medical
facility. Such a lab may have use of a wide variety of diagnostic and
therapeutic equipment useful in rendering medical service to a patient,
such as imaging systems (e.g., fluoroscopy, intracardiac
echocardiography, etc.), an electro-anatomic visualization, mapping and
navigation system, ablation energy sources (e.g., radio frequency (RF)
ablation generator), a recording system (e.g., for ECG, cardiac signals,
etc.), a cardiac stimulator and the like. In a typical configuration, as
seen by reference to FIG. 1, a procedure room 10 (i.e., a sterile
environment) may have an associated control area or room 12, which is
commonly outfitted with one or more control stations 141, 142,
. . . 14n that are operated by one or more control technicians. Each
control station may include a respective display monitor, keyboard and
mouse for use by the technician. Depending on the lab setup, the control
station(s) may be across the room, or outside of the procedure room 10
completely, perhaps configured with a common window to allow the
technician(s) to observe the procedure room through the window. These
control station(s) allow access to and may be used to control the
diagnostic and therapeutic equipment mentioned above.

[0005] In conventional practice, an electrophysiology (EP) physician 16 is
scrubbed into a sterile procedure and typically manipulates one or more
catheters (not shown) in a sterile drape covered body of the patient 18.
The physician's sterile gloved hands are typically engaged with the
catheter handle and shaft next to the patient and he or she is therefore
unable to directly make changes himself to any of the EP systems. The
procedure room 10 typically includes one or more monitors (e.g., an
integrated multi-display monitor 20 is shown) arranged so that the
physician 16 can see the monitor 20 on which is displayed various patient
information being produced by the diagnostic and therapeutic equipment
mentioned above. In FIG. 1, multiple applications, for example, an
electro-anatomic mapping application (e.g., EnSite Velocity®) and an
EP signal acquisition and recording application, direct a visual output
to a respective display area of monitor 20. When changes to an
application are needed, the physician 16 verbalizes such commands to the
control technicians in the control area/room 12 who are working at the
various control stations 141, 142, . . . 14n. The multiple
technicians at multiple control stations use multiple keyboard/mouse sets
to control the multiple applications. The verbal commands between the
physician and the technician occur throughout the procedure.

[0006] For example, the EP physician 16 can verbally communicate (i.e., to
the control technician--a mapping system operator) the desired view of
the map to be displayed, when to collect points, when to separate
anatomic locations, and other details of creating and viewing an anatomic
map. The EP physician 16 can also communicate which signal traces to
show, the desired amplitude, when to drop a lesion marker, and when to
record a segment, to name a few. Where the technician is in a separate
room, communication can be facilitated using radio.

[0007] While some commands are straightforward, for example, "LAO View",
"record that" and "stop pacing", other commands are not as easy to
clearly communicate. For example, how much rotation of a model the
command "rotate a little to the right" means can be different as between
the physician and the technician. This type of command therefore involves
a question of degree. Also, depending on the physician-technician
relationship, other requests related to the mapping system views and
setup can be misinterpreted. For example, a request to "rotate right" may
mean to rotate the model right (i.e., rotate view left) when originating
from one physician but can alternatively mean rotate view right (i.e.,
rotate model left) when coming from another physician. This type of
command therefore involves physician-technician agreement as to
convention. Furthermore, implementation of requests for event markers,
segment recordings, lesion markers and the like can be delayed by the
time it takes the technician to hear, understand and act on a physician's
command. Ambient discussions and/or equipment noise in and around the EP
lab can increase this delay.

[0008] There is therefore a need for improvements in EP lab integration
that minimize or eliminate one or more problems are set forth above.

BRIEF SUMMARY OF THE INVENTION

[0009] One advantage of the methods and apparatuses described, depicted
and claimed herein is that they provide an EP physician with the
capability of directly controlling an EP diagnostic or therapeutic
system, such as an electro-anatomic mapping system. This capability
eliminates the need for the physician to first communicate his/her wishes
to a control technician, who in turn must hear, interpret and act on the
physician's command. The improved control paradigm results in reduced
times for medical procedures.

[0010] A device for allowing a user to control an electro-anatomic mapping
system includes an electronic control unit (ECU) and input means, using
the ECU, for acquiring a user input with respect to a view of an
anatomical model of at least a portion of a body of a patient. The user
input is selected from the group comprising a user touch, a user
multi-touch, a user gesture, a verbal command, a motion pattern of a
user-controlled object, a user motion pattern and a user
electroencephalogram. The ECU is configured to communicate the acquired
input to the mapping system for further processing.

[0011] In an embodiment, the acquired user input can correspond to any of
a variety of mapping systems commands, for example only at least one of:
(1) creating a map with respect to the view; (2) collecting points with
respect to the view; (3) segmenting regions by anatomy with respect to
the view; (4) rotating the view; (5) enlarging or reducing a portion of
the view; (6) panning the view; (7) selecting one of a plurality of maps
for the view; (8) selecting a signal trace; (9) adjusting a signal
amplitude; (10) adjusting a sweep speed; (11) recording a segment; (12)
placing an event marker; (13) placing a lesion marker with respect to the
view; (14) activating a replay feature of a stored, temporally varying
physiologic parameter; and (15) activating a replay of a stored video
clip.

[0012] In an embodiment, the input means includes a touch-responsive
display panel coupled to the ECU. The input means also includes user
interface logic (executed by the ECU) configured to display a user
interface on the touch-responsive display panel. The user interface logic
is further configured to allow a user to interact with the
touch-responsive panel for acquiring the above-mentioned user input with
respect to the anatomical model. The user interface in combination with
the touch-panel allows the user to provide input by way of touch,
multi-touch, and gesture. In a further embodiment, the device further
includes voice recognition logic configured to recognize a set of
predefined verbal commands spoken by the user (e.g., the physician). In a
still further embodiment, the device includes wireless communications
functionality, improving portability of the device within a procedure
room or the control room. In a still further embodiment, the user
interface logic is configured to present a plurality of
application-specific user interfaces associated with a plurality of
different diagnostic or therapeutic systems. Through this capability, the
user can rapidly switch between application-specific user interfaces
(e.g., such as that for an electro-anatomic mapping system, an EP
recording system, an ultrasound imaging system, a cardiac stimulator,
etc.), while remaining bedside of the patient, and without needing to
communicate via a control technician.

[0013] In another embodiment, the input means includes a remote control
having a handle configured to be grasped by the user. The remote control
includes logic configured to acquire the above-mentioned user input. The
user input may include user-controlled motion patterns of the remote
control, as well as user key-presses on the remote control. The device is
also configured to communicate the acquired user input to the mapping
system.

[0014] In yet another embodiment, the input means includes a motion
capture apparatus configured to acquire imaging of movements of the user.
The device includes logic configured to identify a motion pattern using
the acquired imaging from the motion capture apparatus. The logic is
further configured to produce a command, based on the identified motion
pattern, and communicate the command to the electro-anatomic mapping
system for further processing. The motion capture apparatus provides the
capability of receiving input by way of physician gestures (e.g., hand,
arm, leg, trunk, facial, etc.). In a further embodiment, the device
further includes voice recognition logic configured to identify verbal
commands spoken by the user.

[0015] Corresponding methods are also presented.

[0016] The foregoing and other aspects, features, details, utilities, and
advantages of the present disclosure will be apparent from reading the
following description and claims, and from reviewing the accompanying
drawings.

BRIEF DESCRIPTION OF THE DRAWINGS

[0017] FIG. 1 is a block diagram view of a conventional electrophysiology
lab having a sterile procedure room and an associated control room.

[0018] FIG. 2 is a block diagram view of an embodiment of an
electrophysiology lab having a bedside interface device for controlling
diagnostic and therapeutic equipment.

[0019]FIG. 3A is a plan view of a first embodiment of a bedside interface
device comprising a touch panel computer, suitable for use in the EP lab
of FIG. 2, and showing a first application-specific user interface.

[0020] FIG. 3B is an isometric view of a sterile drape configured to
isolate the touch panel computer of FIG. 3A.

[0021]FIG. 4A is a view of a monitor shown in FIG. 2, showing multiple
inset displays associated with a plurality of diagnostic and/or
therapeutic systems.

[0022] FIG. 4B is a view of the monitor of FIG. 4A, showing a zoomed-in
window of the display associated with an electro-anatomic mapping system.

[0023]FIG. 5 is a plan view of the touch panel computer of FIG. 3A
showing a second application-specific user interface.

[0024] FIG. 6 is a plan view of the touch panel computer of FIG. 3A
showing a third application-specific user interface.

[0025] FIG. 7A is a diagrammatic and block diagram view of a second
embodiment of the bedside interface device comprising an electronic wand
system.

[0026] FIG. 7B is a diagrammatic view of a third embodiment of the bedside
interface device wherein a catheter is integrated with the remote control
portion of FIG. 7A.

[0027]FIG. 8 is a diagrammatic and block diagram view of a fourth
embodiment of the bedside interface device comprising a motion capture
apparatus.

[0028] FIGS. 9-10 are diagrammatic views of fifth and sixth embodiments of
the bedside interface device comprising touch responsive surface devices
that can be covered in a sterile bag.

[0029] FIG. 11 is a diagrammatic view of a seventh embodiment of the
bedside interface device comprising a customized joystick that can be
covered in a sterile bag.

[0031] Referring now to the drawings wherein like reference numerals are
used to identify identical or similar components in the various views,
FIG. 2 is a diagrammatic overview of an electrophysiology (EP) laboratory
in which embodiments of the present invention may be used. FIG. 2 shows a
sterile procedure room 10 where an EP physician 16 is set to perform one
or more diagnostic and/or therapeutic procedures. It should be understood
that the separate control area/room 12 of FIG. 1 (not shown in FIG. 2)
may continue to be used in conjunction with the bedside interface device
to be described below. FIG. 2 also shows multi-display monitor 20 as well
as a procedure table or bed 22. While procedure room 10 may include
multiple, individual monitors, monitor 20 may be a multi-display monitor
configured to display a plurality of different input channels in
respective display areas on the monitor. In an embodiment, the monitor 20
may be a commercially available product sold under the trade designation
VantageView® from St. Jude Medical, Inc. of St. Paul, Minn., USA,
which can have a 3840×2160 Quad-HD screen resolution with the
flexibility to accept up to sixteen (16) digital or analog image inputs
while displaying up to eight (8) images on one screen at one time. The
procedure table 22, which may be of conventional construction, is
configured to receive a patient (not shown) on whom diagnostic and/or
therapeutic procedure(s) are to be performed.

[0032] FIG. 2 further shows means or apparatus 24 for facilitating
physician interaction with one or more diagnostic and/or therapeutic
systems. Means or apparatus 24 includes a bedside interface device 26 and
optionally one or more base interfaces 28. Means or apparatus 24 provides
the mechanism for the EP physician 16 to directly interact with such
systems without the need for the intermediate step of verbalizing
commands to a control technician, as described in connection with FIG. 1.
In this regard, bedside interface device 26 is configured to present a
user interface or other input logic with which the user (e.g., the EP
physician 16) can directly interact or from which an input can be
acquired. In multiple embodiments, various modes of interaction are
presented, such as interaction via a user touch, a user multi-touch, a
user gesture, a verbal command, a motion pattern of a user-controlled
device, a user motion pattern and a user electroencephalogram. In
addition, bedside interface device 26 can be configured to communicate
with one or more of the diagnostic/therapeutic systems either wirelessly
(as shown) or via a wired connection (not shown).

[0033] The base interface 28 is configured to interpret and/or facilitate
directing the input acquired by the bedside interface device 26 to the
appropriate one or more diagnostic and/or therapeutic systems (e.g., an
electro-anatomic mapping system). In an embodiment, base interface 28 is
centralized (as shown), wherein all communications with bedside device 26
occur through base interface 28. In a further embodiment, base interface
28 may be functionally distributed, wherein interface functions are
located within each diagnostic or therapeutic system. In a still further
embodiment, communications between bedside interface 26 and certain ones
of the diagnostic/therapeutic systems can be centralized, while
communications with other ones of the diagnostic/therapeutic systems can
occur directly (i.e., separately).

[0034] The means or apparatus 24 addresses a number of the shortcomings of
the conventional practice as described in the Background. For example,
means or apparatus 24 allows the EP physician 16 to directly input levels
of degree, for example, how much to rotate a view, as opposed to trying
to verbally communicate "how much" to a control technician. Further, the
use of means or apparatus 24 avoids the potential confusion that can
sometimes occur between the EP physician and the control technician as to
convention (i.e., does "rotate right" mean rotate the view or the
model?). In addition, the use of means or apparatus 24 reduces or
eliminates the inherent time delay between the time when the EP physician
verbally issues a command and the time when the command is understood and
acted upon by the technician.

[0035] With continued reference to FIG. 2, the physician 16 will typically
have access to a plurality of diagnostic and/or therapeutic systems in
order to perform one or more medical procedures. In the illustrative
embodiment, the physician 16 may have access to a first imaging system,
such as a fluoroscopic imaging system 30, a second imaging system, such
as an intracardiac ultrasound or echocardiography (ICE) imaging system
32, an electro-anatomic positioning, mapping, and visualization system
34, a further positioning system, such as a medical positioning system
(magnetic-field based) 36, a patient data (electrophysiological (EP)
data) monitoring and recording system 38, a cardiac stimulator 40, an EP
data editing/monitoring system 42 and an ablation system 44. FIG. 2
schematically shows a communication mechanism 46 which facilitates
communication between and among the various systems described above. It
should be understood, however, that the communications mechanism 46 may
not necessarily function to enable communications between each and every
system shown.

[0036] The fluoroscopic imaging system 30 may comprise conventional
apparatus known in the art, for example, single plane or bi-plane
configurations. A display area 48 that is shown on monitor 20 corresponds
to the display output of fluoroscopic imaging system 30.

[0037] The intracardiac ultrasound and/or intracardiac echocardiography
(ICE) imaging system 32 may also comprise conventional apparatus known in
the art. For example, in one embodiment, the system 32 may comprise a
commercial system available under the trade designation ViewMate® Z
intracardiac ultrasound system compatible with a ViewFlex® PLUS
intracardiac echocardiography (ICE) catheter, from St. Jude Medical, Inc.
of St. Paul, Minn., USA. The system 32 is configured to provide real-time
image guidance and visualization, for example, of the cardiac anatomy.
Such high fidelity images can be used to help direct diagnosis or therapy
during complex electrophysiology procedures. A display area 50 that is
shown on monitor 20 corresponds to the display output of the ultrasound
imaging system 32.

[0038] The system 34 is configured to provide many advanced features, such
as visualization, mapping, navigation support and positioning (i.e.,
determine a position and orientation (P&O) of a sensor-equipped medical
device, for example, a P&O of a distal tip portion of a catheter). Such
functionality can be provided as part of a larger visualization, mapping
and navigation system, for example, an ENSITE VELOCITY® cardiac
electro-anatomic mapping system running a version of EnSite NavX®
navigation and visualization technology software commercially available
from St. Jude Medical, Inc., of St. Paul, Minn. and as also seen
generally by reference to U.S. Pat. No. 7,263,397 entitled "METHOD AND
APPARATUS FOR CATHETER NAVIGATION AND LOCATION AND MAPPING IN THE HEART"
to Hauck et al., or U.S. Patent Publication No. 2007/0060833 A1 to Hauck
entitled "METHOD OF SCALING NAVIGATION SIGNALS TO ACCOUNT FOR IMPEDANCE
DRIFT IN TISSUE", both owned by the common assignee of the present
invention, and both hereby incorporated by reference in their entireties
as though fully set forth herein. System 34 can be configured to perform
further advanced functions, such as motion compensation and adjustment
functions. Motion compensation may include, for example, compensation for
respiration-induced patient body movement, as described in copending U.S.
patent application Ser. No. 12/980,515, entitled "DYNAMIC ADAPTIVE
RESPIRATION COMPENSATION WITH AUTOMATIC GAIN CONTROL", which is hereby
incorporated by reference in its entirety as though fully set forth
herein. System 34 can be used in connection with or for various medical
procedures, for example, EP studies or cardiac ablation procedures.

[0039] System 34 is further configured to generate and display three
dimensional (3D) cardiac chamber geometries or models, display activation
timing and voltage data to identify arrhythmias, and to generally
facilitate guidance of catheter movement in the body of the patient. For
example, a display area 52 that is shown on monitor 20 corresponds to the
display output of system 34, can be viewed by physician 16 during a
procedure, which can visually communicate information of interest or need
to the physician. The display area 52 in FIG. 2 shows a 3D cardiac model,
which, as will be described below in greater detail, may be modified
(i.e., rotated, zoomed, etc.) pursuant to commands given directly by
physician 16 via the bedside interface device 26.

[0040] System 36 is configured to provide positioning information with
respect to suitably configured medical devices (i.e., those including a
positioning sensor). System 36 may use, at least in part, a magnetic
field based localization technology, comprising conventional apparatus
known in the art, for example, as seen by reference to U.S. Pat. No.
7,386,339 entitled "MEDICAL IMAGING AND NAVIGATION SYSTEM", U.S. Pat. No.
6,233,476 entitled "MEDICAL POSITIONING SYSTEM", and U.S. Pat. No.
7,197,354 entitled "SYSTEM FOR DETERMINING THE POSITION AND ORIENTATION
OF A CATHETER", all of which are hereby incorporated by reference in
their entirety as though fully set forth herein. System 36 may comprise a
gMPS® medical positioning system commercially offered by MediGuide
Ltd. of Haifa, Israel and now owned by St. Jude Medical, Inc. of St.
Paul, Minn., USA. System 36 may alternatively comprise variants, which
employ magnetic field generator operation, at least in part, such as a
combination magnetic field and current field-based system such as the
CARTO® 3 System available from Biosense Webster, and as generally
shown with reference to one or more of U.S. Pat. Nos. 6,498,944 entitled
"Intrabody Measurement," 6,788,967 entitled "Medical Diagnosis, Treatment
and Imaging Systems," and 6,690,963 entitled "System and Method for
Determining the Location and Orientation of an Invasive Medical
Instrument," the entire disclosures of which are incorporated herein by
reference as though fully set forth herein.

[0041] EP monitoring and recording system 38 is configured to receive,
digitize, display and store electrocardiograms, invasive blood pressure
waveforms, marker channels, and ablation data. System 38 may comprise
conventional apparatus known in the art. In one embodiment, system 38 may
comprise a commercially available product sold under the trade
designation EP-WorkMate® from St. Jude Medical, Inc. of St. Paul,
Minn., USA. The system 38 can be configured to record a large number of
intracardiac channels, may be further configured with an integrated
cardiac stimulator (shown in FIG. 2 as stimulator 40), as well as
offering storage and retrieval capabilities of an extensive database of
patient information. Display areas 54, 56 shown on monitor 20 correspond
to the display output of EP monitoring and recording system 38.

[0042] Cardiac stimulator 40 is configured to provide electrical
stimulation of the heart during EP studies. Stimulator 40 can be provided
in either a stand-alone configuration, or can be integrated with EP
monitoring and recording system 38, as shown in FIG. 2. Stimulator 40 is
configured to allow the user to initiate or terminate tachy-arrhythmias
manually or automatically using preprogrammed modes of operation.
Stimulator 40 may comprise conventional apparatus known in the art. In an
embodiment, stimulator 40 can comprise a commercially available cardiac
stimulator sold under the trade designation EP-4® available from St.
Jude Medical, Inc. of St. Paul, Minn., USA. The display area 58 shown on
monitor 20 corresponds to the display output of the cardiac stimulator
40.

[0043] EP data editing/monitoring system 42 is configured to allow editing
and monitoring of patient data (EP data), as well as charting, analysis,
and other functions. System 42 can be configured for connection to EP
data recording system 38 for real-time patient charting, physiological
monitoring, and data analysis during EP studies/procedures. System 42 may
comprise conventional apparatus known in the art. In an embodiment,
system 42 may comprise a commercially available product sold under the
trade designation EP-NurseMate® available from St. Jude Medical, Inc.
of St. Paul, Minn., USA.

[0044] To the extent the medical procedure involves tissue ablation (e.g.,
cardiac tissue ablation), ablation system 44 can be provided. The
ablation system 44 may be configured with various types of ablation
energy sources that can be used in or by a catheter, such as
radio-frequency (RF), ultrasound (e.g. acoustic/ultrasound or HIFU),
laser, microwave, cryogenic, chemical, photo-chemical or other energy
used (or combinations and/or hybrids thereof) for performing ablative
procedures. RF ablation embodiments may and typically will include other
structure(s) not shown in FIG. 2, such as one or more body surface
electrodes (skin patches) for application onto the body of a patient
(e.g., an RF dispersive indifferent electrode/patch), an irrigation fluid
source (gravity feed or pump), and an RF ablation generator (e.g., such
as a commercially available unit sold under the model number IBI-1500T RF
Cardiac Ablation Generator, available from St. Jude Medical, Inc.).

[0045]FIG. 3A is a plan view of a first embodiment of a bedside interface
device comprising a computer 26a, suitable for use in the EP lab of FIG.
2, and showing a first application-specific user interface. The computer
26a includes a touch-responsive display panel and thus may be referred to
hereinafter sometimes as a touch panel computer. The touch panel computer
26a, as shown in inset in FIG. 3A, includes an electronic control unit
(ECU) having a processor 60 and a computer-readable memory 62, user
interface (UI) logic 64 stored in the memory 62 and configured to be
executed by processor 60, a microphone 66 and voice recognition logic 68.
In an embodiment, voice recognition logic 68 is also stored in memory 62
and is configured to be executed by processor 60. In an embodiment, the
touch panel computer 26a is configured for wireless communication to base
interface 28 (best shown in FIG. 2). In addition, the touch panel
computer 26a is configured to draw operating power at least from a
battery-based power source--eliminating the need for a power cable. The
resulting portability (i.e., no cables needed for either communications
or power) allows touch panel computer 26a to be carried around by the EP
physician 16 or other lab staff to provide control over the linked
systems (described below) while moving throughout the procedure room 10
or even the control room 12. In another embodiment, touch panel computer
26a can be wired for one or both of communications and power, and can
also be fixed to the bedrail or in the sterile field.

[0046] In the illustrated embodiment, the UI logic 64 is configured to
present a plurality of application-specific user interfaces, each
configured to allow a user (e.g., the EP physician 16) to interact with a
respective one of a plurality of diagnostic and/or therapeutic systems
(and their unique interface or control applications). As shown in FIG.
3A, the UI logic 64 is configured to present on the touch panel surface
of computer 26a a plurality of touch-sensitive objects (i.e., "buttons",
"flattened joystick", etc), to be described below. In the illustrative
embodiment, the UI logic 64 produces a first, application-selection group
of buttons, designated as group 70, and which are located near the top of
the touch panel. Each of the buttons in group 70 are associated with a
respective diagnostic and/or therapeutic system (and control or interface
application therefore). For example, the six buttons labeled "EnSite",
"WorkMate", "EP4", "NurseMate", "MediGuide", "ViewMate" correspond to
electro-anatomic mapping system 34 (for mapping control), EP recording
system 38 (for patient data recording control), stimulator 40 (for
stimulator control), EP data editing and monitoring system 42 (for
charting) and ultrasound imaging system 32 (for ultrasound control),
respectively.

[0047] When a user selects one of the buttons in group 70, the UI logic 64
configures the screen display of computer 26a with an
application-specific user interface tailored for the control of and
interface with the particular EP system selected by the user. In FIG. 3A,
the "EnSite" system is selected, so the UI logic 64 alters the visual
appearance of the "EnSite" button so that it is visually distinguishable
from the other, non-selected buttons in group 70. For example, when
selected, the "EnSite" button may appear depressed or otherwise shaded
differently than the other, non-selected buttons in group 70. This always
lets the user know what system is selected. The UI logic 64, in an
embodiment, also maintains the application-selection buttons in group 70
at the top of the screen regardless of the particular application
selected by the user. This arrangement allows the user to move from
system (application) to system (application) quickly and control each one
independently.

[0048] With continued reference to FIG. 3A, UI logic 64 presents an
application-specific user interface tailored and optimized for control of
and interaction with system 34. This user interface includes a second,
common-task group of selectable buttons, designated group 72, a third,
view-mode group of selectable buttons, designated group 74, a fourth,
view-select group of selectable buttons, designated group 76, a flattened
joystick 78 configured to receive view-manipulation input from the user,
a voice recognition control button 80, and a settings button 82. Each
group will be addressed in turn.

[0049] The second group 72 of buttons includes a listing of common tasks
performed by an EP physician when interacting with system 34. Each of the
buttons in group 72 are associated with a respective task (and resulting
action). For example, the five buttons in group 72 are labeled "Zoom In",
"Zoom Out", "Add Lesion", "Freeze Point", and "Save Point". The "Zoom In"
and "Zoom Out" buttons allow the user to adjust the apparent size of the
3D model displayed on monitor 20 (i.e., enlarging or reducing the 3D
model on the monitor).

[0050] For example, FIG. 4A is a view of the monitor 20 of FIG. 2, showing
multiple inset displays for different applications, where the display
area (window) 521 shows the EnSite® display output of a 3D
electro-anatomic model at a first magnification level. FIG. 4B is a
further view of monitor 20, showing a zoomed-in view of the same display
area (window), now designated 522, which has an increased
magnification level and thus apparent size. This change of course allows
the physician to see details in window 522 that may not be easy to
see in window 521.

[0051] Referring again to FIG. 3A, the "Add Lesion" button is configured
to add a lesion marker to the 3D model. Other commands can be also be
executed using the "Freeze Point" and "Save Point" buttons. It should be
understood that variations are possible.

[0052] Each of the buttons in group 74 are associated with a respective
display mode, which alters the display output of system 34 to suit the
wishes of the physician. For example, the three selectable buttons
labeled "Dual View", "Right View", and "Map View" re-configure the
display output of system 34, as will appear on monitor 20.

[0053] Each of the buttons in group 76 are associated with a respective
viewpoint from which the 3D electro-anatomic model is "viewed" (i.e., as
shown in window 52 on monitor 20). Three of the five selectable buttons,
namely those labeled "LAO", "AP", and "RAO", allow the user to
reconfigure the view point from which the 3D electro-anatomic model is
viewed (i.e., left anterior oblique, anterior-posterior, right anterior
oblique, respectively). The remaining two buttons, namely those labeled
"Center at Surface" and "Center at Electrode" allow the user to invoke,
respectively, the following functions: (1) center the anatomy shape in
the middle of the viewing area; and (2) center the current mapping
electrode or electrodes in the middle of the viewing area.

[0054] The flattened joystick 78 is a screen object that allows the user
to rotate the 3D model displayed in the window 52. In addition, as the
point of contact (i.e., physician's finger) with the joystick object 78
moves from the center or neutral position, for example at point 83,
towards the outer perimeter (e.g., through point 84 to point 86), the
magnitude of the input action increases. For example, the acceleration of
rotation of the model or cursor will increase. While FIG. 3A shows the
joystick object 78 as having three (3) gradations or concentric bands, it
should be appreciated that this is for clarity only and not limiting in
number. For example, in an embodiment, a relatively larger number of
gradations or bands, such as ten (10), may be provided so as to
effectively provide for a substantially continuous increase in
sensitivity (or magnitude) as the point of contact moves toward the outer
radius. In another embodiment, a single gradient may be continuous from
the center position, point 83, to the outer edge of the joystick object
78, with the centermost portion of the gradient being the brightest in
intensity or color and the outermost portion of the gradient being the
darkest in intensity or color, for example. In yet another embodiment, a
single gradient may be continuous from the center position, point 83, to
the outer edge of the joystick object 78, with the centermost portion of
the gradient being the darkest in intensity or color and the outermost
portion of the gradient being brightest in intensity or color, for
example.

[0055] In a further embodiment, UI logic 64 can be further configured to
present an additional button labeled "Follow Me" (not shown), which, when
selected by the user, configures the electro-anatomic mapping system 34
for "follow me" control. This style of control is not currently available
using a conventional keyboard and mouse interface. For "follow me"
control, UI logic 64 is configured to receive a rotation input from the
user via the touch panel (e.g., joystick 78); however, the received input
is interpreted by system 34 as a request to rotate the endocardial
surface rendering (the "map") while maintaining the mapping catheter
still or stationary on the display. In an embodiment, the physician can
set the position and orientation of the mapping catheter, where it will
remain stationary after the "Follow Me" button is selected.

[0056] Another feature of the touch panel computer 26a is that it
incorporates, in an embodiment, voice recognition technology. As
described above, computer 26a includes microphone 66 for capturing speech
(audio) and voice recognition logic 68 for analyzing the captured speech
to extract or identify spoken commands. The voice recognition feature can
be used in combination with the touch panel functionality of computer
26a. The microphone 66 may comprise conventional apparatus known in the
art, and can be a voice recognition optimized microphone particularly
adapted for use in speech recognition applications (e.g., an
echo-cancelling microphone). Voice recognition logic 68 may comprise
conventional apparatus known in the art. In an embodiment, voice
recognition logic 68 may be a commercially available component, such as
software available under the trade designation DRAGON DICTATION®
speech recognition software.

[0057] In an embodiment, computer 26a is configured to recognize a defined
set of words or phrases adapted to control various functions of the
multiple applications that are accessible or controllable by computer
26a. The voice recognition feature can itself be configured to recognize
unique words or phrases to selectively enable or disable the voice
recognition feature. Alternatively (or in addition to), a button, such as
button 80 in FIG. 3A, can be used to enable or disable the voice
recognition feature. In this regard, the enable/disable button can be
either a touch-sensitive button (i.e., screen object), or can be hardware
button.

[0058] Voice recognition logic 68 is configured to interact with the
physician or other user to "train" the logic (e.g., having the user speak
known words) so as to improve word and/or phrase recognition. The
particulars for each user so trained can be stored in a respective voice
(user) profile, stored in memory 62. For example, in FIG. 3A, the
currently active voice profile is listed in dashed-line box 89. In an
embodiment, each user can have unique commands, which may also be stored
in the respective voice profile. In a further embodiment, the language
need not be English, and can be other languages. This flexibility as to
language choice enlarges the audience of users who can use the device
26a. The voice recognition feature presents a number of advantages,
including the fact that the physician 16 does not have to remove his/her
hands from the catheter or other medical device being manipulated. In
addition, the absence of contact or need to touch computer 26a maintains
a sterile condition. The voice recognition feature can also be used
either alone or in combination with other technologies.

[0059] With continued reference to FIG. 3A, UI logic 64 also presents a
"Settings" button 82. When the "Settings" button 82 is selected, UI logic
64 generates another screen display that allows the user to adjust and/or
set/reset various settings associated with the application currently
selected. In an embodiment, the "Settings" button can also allow
adjustment of parameters that are more global in nature (i.e., apply to
more than one application). For example only, through "Settings", the
physician or another user can edit all of the phrases associated with a
particular physician or specify a timeout (i.e., the elapsed amount of
time, after which the computer will stop listening (or not) for voice
commands). The physician or another user can also edit miscellaneous
parameters, such as communication settings and the like.

[0060] FIG. 3B is an isometric view of a sterile drape 88 configured to
protect the touch panel computer 26a of FIG. 3A from contamination and to
maintain the physician's sterility. Conventional materials and
construction techniques can be used to make drape 88.

[0061]FIG. 5 is a plan view of touch panel computer 26a showing a
different application-specific user interface, now relating to EP
monitoring and recording system 38 (i.e., "EP-WorkMate"). In the
illustrative embodiment, UI logic 64 produces the same
application-selection group 70 of buttons along the top of the touch
panel, for quick and easy movement by the user between applications. A
second, common-tasks group of buttons, designated as group 90, are shown
below group 70. For example, the three buttons labeled "Record",
"Update", and "Add Map Point" can execute the identified function
Likewise, additional groups of buttons are shown, grouped by function,
for example the signals-adjustment group 92, the events group 94, the
timer group 96 and the print group 98. It should be understood that
variations are possible, depending on the items that can be adjusted or
controlled on the destination system. It warrants emphasizing that UI
logic 64 thus presents a unique user interface tailored to the
requirements of the particular application selected. Each group includes
items that are commonly asked for by the physician. For example, in the
signals group 92, the Speed +/- buttons can be used to change the viewed
waveform sweep speed as the physician may need more or less detail; the
Page +/- buttons can be used to change the page of signals being viewed
(e.g., from surface ECG signals to intracardiac signals); and the
Amplitude +/- buttons can be used to change the signal amplitudes up or
down. As a further example, in the Events group 94, the enumerated Events
buttons cause a mark to be created in the patient charting log to
indicate a noteworthy (i.e., important) item or event, such as the
patient was just defibrillated or entered a tachy-arrhythmia. Note that
these items are all user definable and speakable (capable of being tied
to the voice recognition function). The physician also needs to keep
track of certain periods of time. Thus, in the Timer group 96, the timer
buttons can be used to keep track of such periods of time, for example,
such as a certain time after an ablation (e.g., 30 minutes) to verify
that the ablation procedure is still effective. Finally, regarding the
print group 98, various print buttons are provided so as to avoid
requiring a physician to verbally indicate (e.g., by way of shouting out
"print that document to the case" or the like) and to include such
documents in a final report.

[0062] FIG. 6 is a plan view of touch panel computer 26a showing in
exemplary fashion a further, different application-specific user
interface relating to the ultrasound imaging system 32 ("ViewMate"). As
with the other application-specific user interfaces, the user interface
presented in FIG. 6 repeats the common, application-selection group of
buttons, designated group 70. A further group of buttons and adjustment
mechanisms are located in group 100. The controls (buttons, sliders)
provided for this user interface completely eliminate the need to have a
separate ultrasound keyboard to control the console. The user interface
shown can be different, independent on the kind of machine being
controlled, but at a minimum may typically provide a way to control the
receive gain, the depth setting, the focus zone, the TGC (i.e., time gain
compensation) curve, the monitoring mode (e.g., B, M, color Doppler,
Doppler), image recording, as well as other image attributes and states.
Note, trackpad object 101 is shown in the center of the user interface.
The capability provided by UI logic 64 to rapidly switch applications and
present to the bedside user an application-specific user interface
minimizes or eliminates many of the shortcomings set forth in the
Background.

[0063] It should be understood that variations in UI logic 64 are
possible. For example, certain applications can be linked (in software)
so that multiple applications can be controlled with a single command
(e.g., the Record command). In another embodiment, UI logic 64 can be
configured to provide additional and/or substitute functions, such as,
without limitation, (1) map creation; (2) collecting points; (3)
segmenting regions by anatomy; (4) map view (rotate and zoom); (5)
select/manipulate a number of maps and view each; (6) selection of signal
trace display; (7) adjust EP signal amplitude; (8) sweep speed; (9)
provide single button (or touch, multi-touch, gesture) for recording a
segment, placing an event marker, and/or placing a lesion marker.

[0064] It should be further understood that the screen layouts in the
illustrative embodiment are exemplary only and not limiting in nature.
The UI logic 64 can thus implement alternative screen layouts for
interaction by the user. For example, while the screen displays in FIGS.
3A, 5 and 6 show an approach that incorporates the top level menu items
on every screen, multi-level menus can also be used. For example, the
screen layouts can be arranged such that a user descends down a series of
screens to further levels of control. To return to upper levels (and to
the "home" screen), a "Back" button or the like can be provided.
Alternatively, a "Home" button can be provided.

[0065] In a still further embodiment, UI logic 64 can be configured for
bi-directional display of information, for example, on the
touch-responsive display panel. As one example, the "EnSite" user
interface (FIG. 3A) can be configured so that the EnSite® model is
sent to the computer 26a and displayed on the touch-responsive display
panel. The user interface provided by UI logic 64 can allow the user to
drag his or her finger on the panel to rotate the model. The display of
the model provides context with respect to the act of dragging. Other
information can be displayed as well, such as a waveform. In various
embodiments, all or a portion of the items/windows displayed on monitor
20 (see, e.g., FIGS. 2, 4A, and 4B) may be displayed or mirrored on the
touch-responsive display panel. For example, display area or window 52
may be displayed on the touch-responsive display panel allowing the
physician or other user to directly modify the features of window 52 at
the patient's bedside. Other display areas/windows, such as windows 50,
54, 56, 58, and/or 48 (see FIG. 2) may also be displayed and/or modified
on the touch-panel display panel. One further example involves displaying
feedback information or messages originating from the various devices or
systems back to the touch-responsive display panel. In this regard, the
UI logic 64 can configure any of the user-interfaces to have a message
area, which can show informational messages, warning messages or critical
error messages for viewing by the user. The message area feature provides
a way to immediately alert the physician to such messages, rather than
the physician having to watch for messages on multiple displays.

[0066] FIG. 7A is a diagrammatic and block diagram view of a second
embodiment of the bedside interface device, comprising an electronic wand
system 26b. As with touch panel computer 26a, wand system 26b is
configured to allow the EP physician to take control, bedside of the
patient, of an EP diagnostic or therapeutic system, such as the
electro-anatomic mapping system 34. The wand system 26b includes a
wireless remote control portion 102, an optical emitter portion 104, and
a base interface 28b, which may be coupled to the desired, target EP
system through either a wired or wireless connection. The wand system 26b
incorporates remote control technology, and includes the ability to
detect and interpret motion of the remote control indicative of an EP
physician's command or other instruction, detect and interpret
key-presses on the remote control, and/or detect and interpret
motion/keypress combinations.

[0067] Since the wand system 26b is contemplated as being used in the
sterile procedure room, multiple embodiments are contemplated for
avoiding contamination. In this regard, wand system 26b may be configured
with a disposable remote control portion 102, with a reusable remote
control portion 102 that is contained within an enclosure compatible with
sterilization procedures, with a reusable remote control portion 102
adapted to be secured in a sterilization-compatible wrapper, or with a
reusable remote control portion 102 that is encased in a sterile but
disposable wrapper.

[0068] With continued reference to FIG. 7A, remote control portion 102 may
include an optical detector 106, an electronic processor 108, a memory
110, an optional accelerometer 112 and a wireless transmitter/receiver
114. The processor 108 is configured to execute a control program that is
stored in memory 110, to achieve the functions described below. The
optical emitter 104 is configured to emit a light pattern 105 that can be
detected and recognized by optical detector 106. For example, the light
pattern may be a pair of light sources spaced apart by a predetermined,
known distance. The control program in remote 102 can be configured to
assess movement of the light pattern 105 as detected by detector 106
(e.g., by assessing a time-based sequence of images captured by detector
106). For example, in the exemplary light pattern described above,
processor 108 can be configured to determine the locations of the light
sources (in pixel space). In an embodiment, the control program in remote
102 may only discern the light pattern 105 itself (e.g., the locations in
pixel space) and transmit this information to base interface 28b, which
in turn assesses the movement of the detected light pattern in order to
arrive at a description of the motion of the remote 102. In a still
further embodiment, various aspects of the processing may be divided
between processor 108 and a processor (not shown) contained in base
interface 28b. The processor 106 communicates with base interface 28b via
the wireless transmitter/receiver 114, which may be any type of wireless
communication method now known or hereafter developed (e.g., such as
those technologies or standards branded Bluetooth®, Wi-Fi®, etc.).
The processor 108 is configured to transmit wirelessly to interface 28b
the detected keypresses and information concerning the motion of the
remote control 102 (e.g., the information about or derived from the
images from the optical detector 106). In an embodiment, the motion of
remote control 102 may also be determined, or supplemented by, readings
from accelerometer 112 (which may be single-axis or multi-axis, such as a
3-axis accelerometer). In some instances, rapid motion may be better
detected using an accelerometer than using optical methods. In an
embodiment, electronic wand system 26b may be similar to (but differing
in application, as described herein) a commercially available game
controller sold under the trade designation Wii Remote Controller, from
Nintendo of America, Inc.

[0069] Either the remote 102 or the base interface 28b (or both,
potentially in some division of computing labor) is configured to
identify a command applicable to the one of the EP diagnostic/therapeutic
systems, such as electro-anatomic mapping system 34, based on the
detected motion of the remote 102. Alternatively, the command may be
identified based on a key press, or a predetermined motion/key press
combination. Once the remote 102 and/or interface 28b identifies the
command it is transmitted to the appropriate EP system. In an
electro-anatomic mapping system embodiment, the wireless remote control
102 is configured to allow an EP physician to issues a wide variety of
commands, for example only, any of the commands (e.g., 3D model rotation,
manipulation, etc.) described above in connection with touch panel
computer 26a. By encoding at least some of the control through the
wireless remote control 102 that the EP physician controls, one or more
of the shortcomings of conventional EP labs, as described in the
Background, can be minimized or eliminated. As with touch panel computer
26a, electronic wand system 26b can reduce procedure times as the EP
physician will spend less time playing "hot or cold" with the mapping
system operator (i.e., the control technician), but instead can set the
display to his/her needs throughout the medical procedure.

[0070] FIG. 7B shows a further embodiment, designated interface device
26c. Interface device 26 integrates the remote control 102 described
above into the handle of a catheter 115. Through the foregoing, the
physician need not take his hands off the catheter, but rather can issue
direct, physical commands (e.g., via key-presses) while retaining control
of the catheter. Additionally, one or more of the keys or a slider switch
on the catheter handle may serve as a safety mechanism to prevent
inadvertent activation of one or more commands while operating the
catheter. In such an embodiment, after advancing the catheter into a
patient's body, the safety mechanism may be deactivated or otherwise
turned off such that the physician can issue commands and then he or she
may reactivate or turn on the safety mechanism and resume manipulating
the catheter without fear of modifying the view or model shown on an
on-screen display, for example. The catheter 115 may further comprise one
or more electrodes on a distal portion of the catheter shaft and a manual
or motorized steering mechanism (not shown) to enable the distal portion
of the catheter shaft to be steered in at least one direction. In at
least one embodiment, the catheter handle may be generally symmetric on
opposing sides and include identical or nearly identical sets of controls
on opposing sides of the handle so that a physician need not worry about
which side of the catheter handle contains the keys. In another
embodiment, the catheter handle may be generally cylindrical in shape and
include an annular and/or rotatable control feature for issuing at least
one command, again so the physician need not worry about the catheter
handle's orientation in his or her hand(s). Exemplary catheters, handles,
and steering mechanisms are shown and described in U.S. Pat. No.
5,861,024 to Rashidi, U.S. patent application publication no.
2010/0314031 to Heideman et al., U.S. Pat. No. 7,465,288 to Dudney et
al., and U.S. Pat. No. 6,671,533 to Chen et al., each of which is hereby
incorporated by reference as though fully set forth herein.

[0071]FIG. 8 is a diagrammatic and block diagram view of a fourth
embodiment of the bedside interface device, comprising a motion capture
apparatus 26d. As with touch panel computer 26a, wand system 26b and
integrated system 26c, motion capture apparatus 26d is configured to
allow the EP physician to take control, bedside of the patient, of an EP
diagnostic or therapeutic system, such as electro-anatomical mapping
system 34. The motion capture apparatus 26d includes a capture apparatus
116 having both an optical sub-system 118 and a microphone sub-system 120
where the apparatus 116 is coupled to a base interface 28b. The apparatus
116 is configured to optically detect the motion or physical gestures of
the EP physician or other user when such movements occur within a sensing
volume 122. The base interface 28b may be coupled to the desired, target
EP system through either a wired or wireless connection.

[0072] The motion capture apparatus 26d includes the capability to detect
hand/arm/leg/trunk/facial motions (e.g., gestures) of the EP physician or
other user and translate the detected patterns into a desired command.
Apparatus 26d also includes audio capture and processing capability and
thus also has the capability to detect speech and translate the same into
desired commands. In an embodiment, apparatus 26d is configured to detect
and interpret combinations and sequences of gestures and speech into
desired commands. The base interface 28b is configured to communicate the
commands (e.g., rotation, zoom, pan of a 3D anatomical model) to the
appropriate EP diagnostic or therapeutic system (e.g., the
electro-anatomic mapping system 34). In an embodiment, the motion capture
apparatus 26d may comprise commercially available components, for
example, the Kinect® game control system, available from Microsoft,
Redmond, Wash., USA. A so-called Kinect® software development kit
(SDK) is available, which includes drivers, rich application programming
interfaces (API's), among other things contents, that enables access to
the capabilities of the Kinect® device. In particular, the SDK allows
access to raw sensor streams (e.g., depth sensor, color camera sensor,
and four-element microphone array), skeletal tracking, advanced audio
(i.e., integration with Windows speech recognition) as well as other
features.

[0073] Since there is no contact contemplated by EP physician 16 during
use of motion capture apparatus 26d, contamination and subsequent
sterilization issues are eliminated or reduced. In addition, the lack of
contact with apparatus 26d for control purposes allows the EP physician
to keep his hands on the catheter or other medical device(s) being
manipulated during an EP procedure. By encoding at least some of the
control through the motion capture apparatus 26d, with which the EP
physician interacts, one or more of the shortcomings of conventional EP
labs, as described in the Background, can be minimized or eliminated. As
with the previous embodiments, the motion capture apparatus 26d can
reduce procedure times.

[0074] It should be understood that variations are possible. For example,
the motion capture apparatus 26d can be used in concert with sensors
and/or emitters in a sterile glove to assist the apparatus 26d to
discriminate commands intended to be directed to one of the EP systems,
versus EP physician hand movements that result from his/her manipulation
of the catheter or medical device, versus other movement in the EP lab in
general. In another embodiment, the motion capture apparatus 26d may
discriminate such commands by being "activated" by a user when a specific
verbal command is issued (e.g., "motion capture on") and then
"deactivated" by the user when another specific verbal command is issued
(e.g., "motion capture off").

[0075] FIGS. 9-10 are diagrammatic views of fifth and sixth embodiments of
the bedside interface device, comprising touch responsive devices. FIGS.
9 and 10 show touch-screen mouse pad devices 26e and 26f, respectively.
These devices can be covered in a sterile bag. The EP physician 16 can
move the mouse cursor from application to application and control each
such application independently. Devices 26e, 26f may comprise
conventional apparatus known in the art.

[0076] FIG. 11 is a diagrammatic view of a seventh embodiment of the
bedside interface device comprising a customized joystick 26g. Joystick
26g can also be covered in a sterile bag. The device 26g can be used to
be provide application-specific control a particular application
function(s), such as rotating a 3D model (system 34), adding lesion
markers, and the like.

[0077] FIGS. 12-13 are diagrammatic views of eighth and ninth embodiments
of the bedside interface device comprising holographic mouse and keyboard
input devices, respectively. Holographic mouse 26h deploys light beam
pattern 124, which is used by the mouse 26h to acquire user input (i.e.,
movement of the physician's finger, instead of moving a conventional
mouse). The movement input can be used in the same manner as that
obtained from a conventional mouse. Holographic keyboard 26i also deploys
a light beam pattern 126 corresponding to a keyboard. A physician's
finger can be used to "select" the key much in the same manner as a
conventional keyboard, but without any physical contact. Devices 26h, 26i
have the advantage of being sterile without any disposables, and can
incorporate wireless communications and may be powered using batteries
(i.e., no cables needed).

[0078] It should be understood that variations are possible. For example,
in a further embodiment, primary control by the physician in manipulating
or interacting with the mapping system may be through use of voice
control alone (i.e., a microphone coupled with voice recognition logic),
apart from its inclusion with other modes or devices for user interaction
described above. In a still further embodiment, the physician can be
equipped with headgear that monitors head movements to determine at what
location on the screen/monitor the physician is looking. In effect, such
headgear can act as a trackball to move or otherwise manipulate an image
(or view of a model) on the monitor in accordance with the physician's
head movements. In a yet further embodiment, the physician can be
equipped with headgear that monitors head movements and/or also monitors
brainwave patterns (e.g., to record a user electroencephalogram (EEG)).
Such monitored data can be analyzed to derive or infer user input or
commands for controlling an image (or view of a model), as described
above. An EEG-based embodiment may comprise conventional apparatus known
in the art, for example, commercially available products respectively
sold under the trade designation MindWave® headset from NeuroSky,
Inc., San Jose, Calif., USA, or the Emotiv EPOC® personal interface
neuroheadset from Emotiv, Kwun Tong, Hong Kong. In a still further
embodiment, the physician can be equipped with an eye tracking apparatus,
wherein monitored eye movements constitute the user input to be
interpreted by the system (e.g., the eye movements can be interpreted as
a cursor movement or other command).

[0079] It should also be appreciated that while the foregoing description
pertains to an EP physician manually controlling a catheter through the
use of a manually-actuated handle or the like, other configurations are
possible, such as robotically-actuated embodiments. For example, a
catheter movement controller (not shown) described above may be
incorporated into a larger robotic catheter guidance and control system,
for example, as seen by reference to U.S. application Ser. No. 12/751,843
filed Mar. 31, 2010 entitled ROBOTIC CATHETER SYSTEM (published as U.S.
patent application publication no. 2010/0256558), owned by the common
assignee of the present invention and hereby incorporated by reference in
its entirety as though fully set forth herein. Such a robotic catheter
system may be configured to manipulate and maneuver catheters within a
lumen or a cavity of a human body, while the bedside interface devices
described herein can be used to access and control the EP diagnostic
and/or therapeutic systems. In at least one embodiment, a bedside
interface device as described herein may also be used to access and
control the robotic catheter system.

[0080] In accordance with another embodiment, an article of manufacture
includes a computer storage medium having a computer program encoded
thereon, where the computer program includes code for acquiring user
input based on at least one of a plurality of input modes, such as by
touch, multi-touch, gesture, motion pattern, voice recognition and the
like, and identifying one or more commands or requests for an EP
diagnostic and/or therapeutic system. Such embodiments may be configured
to execute one or more processors, multiple processors that are
integrated into a single system or are distributed over and connected
together through a communications network, and where the network may be
wired or wireless.

[0081] It should be understood that while the foregoing description
describes various embodiments of a bedside interface device in the
context of the practice of electrophysiology, and specifically
catheterization, the teachings are not so limited and can be applied to
other clinical settings.

[0082] It should be understood that the an electronic control unit as
described above may include conventional processing apparatus known in
the art, capable of executing pre-programmed instructions stored in an
associated memory, all performing in accordance with the functionality
described herein. It is contemplated that the methods described herein
may be programmed, with the resulting software being stored in an
associated memory and where so described, may also constitute the means
for performing such methods. Implementation of an embodiment of the
invention, in software, in view of the foregoing enabling description,
would require no more than routine application of programming skills by
one of ordinary skill in the art. Such a system may further be of the
type having both ROM, RAM, a combination of non-volatile and volatile
(modifiable) memory so that the software can be stored and yet allow
storage and processing of dynamically produced data and/or signals.

[0083] Although numerous embodiments of this invention have been described
above with a certain degree of particularity, those skilled in the art
could make numerous alterations to the disclosed embodiments without
departing from the spirit or scope of this invention. All directional
references (e.g., plus, minus, upper, lower, upward, downward, left,
right, leftward, rightward, top, bottom, above, below, vertical,
horizontal, clockwise, and counterclockwise) are only used for
identification purposes to aid the reader's understanding of the present
invention, and do not create limitations, particularly as to the
position, orientation, or use of the invention. Joinder references (e.g.,
attached, coupled, connected, and the like) are to be construed broadly
and may include intermediate members between a connection of elements and
relative movement between elements. As such, joinder references do not
necessarily infer that two elements are directly connected and in fixed
relation to each other. It is intended that all matter contained in the
above description or shown in the accompanying drawings shall be
interpreted as illustrative only and not limiting. Changes in detail or
structure may be made without departing from the spirit of the invention
as defined in the appended claims.